Related Experiment Video
Updated: Aug 10, 2026
08:49
Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
Published on: October 16, 2013
Anaesthetics and the rate corrected interval: learning from droperidol?
1Department of Anaesthesia, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand. shiptonea@xtra.co.nz
Current Opinion in Anaesthesiology
|March 15, 2006
Summary
Long QT syndrome (LQTS) management requires careful preoperative preparation to reduce perioperative arrhythmias. Advances in understanding LQTS pathophysiology and genetic mutations inform future therapeutic strategies for this cardiac condition.
Area of Science:
- Cardiology
- Genetics
- Pharmacology
Background:
- Long QT syndrome (LQTS) poses risks of malignant ventricular arrhythmias during anesthesia.
- Genetically susceptible individuals may present with normal QT intervals but develop intraoperative arrhythmias.
- Perioperative physiological disturbances and medications can prolong the QT interval.
Purpose of the Study:
- To review recent advances in LQTS pathophysiology and management.
- To discuss preclinical drug testing for QT prolongation.
- To explore perioperative considerations and future therapeutic strategies for LQTS.
Main Methods:
- Review of recent scientific literature on LQTS.
- Discussion of genetic discoveries and identified mutations.
- Analysis of acquired LQTS mechanisms, focusing on potassium ion channel blockade.
- Evaluation of preclinical drug assessment methods for QT prolongation potential.
Main Results:
- Over 300 mutations identified across seven ion channel genes.
- Acquired LQTS often involves blockade of the delayed rectifier potassium ion current.
- Drugs that do not increase transmural dispersion of repolarization have lower arrhythmia risk.
- Diagnostic DNA testing aids in family screening for LQTS.
Conclusions:
- Droperidol can induce serious cardiac arrhythmias due to QT prolongation.
- Understanding LQTS pathophysiology aids in developing targeted therapies.
- Preclinical drug testing is crucial for assessing QT prolongation potential.
- Future therapies may involve sodium antagonists, potassium channel activators, and protein kinase inhibitors.
Related Concept Videos
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:22Stages of General Anesthesia
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:20Inhalational Anesthetics: Overview
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:13Local Anesthetics: Pharmacokinetics
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...